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When appealing denials, clinics can reference the pathophysiology: intrinsic factor deficiency blocks B12 absorption regardless of oral dose, making injection the only viable replacement route

Older adults are also at a higher risk of B12 deficiency due to decreased stomach acid levels, which are needed to separate B12 from protein in the diet for absorption

In such cases, our healthcare professionals may recommend Vitamin B12 injections

If your pharmacy includes B12 at a lower concentration, you may want to supplement with additional oral or sublingual B12 between injections, especially at lower semaglutide doses where injection volume (and therefore B12 delivery) is minimal